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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. Jul 19, 2026; 16(7): 117775
Published online Jul 19, 2026. doi: 10.5498/wjp.117775
Watson caring theory-based encouragement interventions for pain and anxiety in stage III-IV pressure ulcer patients
Jian Xing, Yuan-Ji Jia, Jia-Qi Xin, Jing-Yi Liu, Yue Cui, Hong-Wei Zhang
Jian Xing, Interventional Operating Room, The Affiliated Central Hospital of Shenyang Medical College, Shenyang 110024, Liaoning Province, China
Yuan-Ji Jia, Department of Burn and Wound Surgery, The Affiliated Central Hospital of Shenyang Medical College, Shenyang 110024, Liaoning Province, China
Jia-Qi Xin, Department of Rehabilitation Medicine, The Affiliated Central Hospital of Shenyang Medical College (Huanggu Campus), Shenyang 110024, Liaoning Province, China
Jing-Yi Liu, Central Operating Room, The Affiliated Central Hospital of Shenyang Medical College, Shenyang 110024, Liaoning Province, China
Yue Cui, Emergency Department, The Affiliated Central Hospital of Shenyang Medical College, Shenyang 110024, Liaoning Province, China
Hong-Wei Zhang, Emergency Operating Room, The Affiliated Central Hospital of Shenyang Medical College, Shenyang 110024, Liaoning Province, China
Author contributions: Zhang HW designed this research; Xing J and Jia YJ conducted the literature search; Xing J, Jia YJ, Xin JQ, Liu JY, and Cui Y collected the cases; Xin JQ, Liu JY, Cui Y performed the data statistics and analysis; Zhang HW checked the overall results of the paper; all authors read and verified, and confirmed the final manuscript content.
Institutional review board statement: The research was reviewed and approved by The Central Hospital Affiliated to Shenyang Medical College.
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: No conflict of interest is associated with this work.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: No other data available.
Corresponding author: Hong-Wei Zhang, Chief Nurse, Emergency Operating Room, The Affiliated Central Hospital of Shenyang Medical College, No. 5 Nanqi West Road, Tiexi District, Shenyang 110024, Liaoning Province, China. 13998886678@163.com
Received: January 13, 2026
Revised: February 5, 2026
Accepted: March 27, 2026
Published online: July 19, 2026
Processing time: 164 Days and 9.1 Hours
Abstract
BACKGROUND

Infected stage III-IV pressure ulcers constitute a major challenge in the field of clinical nursing; patients often experience severe pain, serious infection, and malnutrition, and the healing process is typically slow. Furthermore, they frequently suffer from negative emotions such as anxiety and depression, which significantly impact their prognosis and quality of life. Traditional nursing focuses on wound treatment and infection control, but pays relatively insufficient attention to psychological and emotional support for patients. The Watson Care Theory emphasizes person-centered holistic care. By establishing a trusting caring relationship, it enhances the patient’s inner strength and rehabilitation belief.

AIM

To explore the application effect of encouragement-based interventions guided by Watson’s caring theory in the care of patients with stage III-IV pressure ulcer infections, analyze its impact on pain and anxiety, and examine its correlation with prognostic indicators, thereby providing a theoretical basis and practical reference for clinical pressure ulcer care.

METHODS

A total of 156 patients with stage III-IV pressure ulcer infections admitted to the Wound Repair Center and Burn Wound Ward of The Affiliated Central Hospital of Shenyang Medical College from February 27, 2025, to August 27, 2025, were selected as the study subjects. They were randomly divided into a control group and a study group using a random number table, with 78 patients in each group. The control group received vacuum sealing drainage combined with conventional care, including dynamic wound monitoring and nutritional support. The study group received encouragement-based interventions guided by Watson's Caring Theory in addition to the control group's treatment. The intervention period for both groups was 8 weeks. The total effective rate of wound healing, wound healing time, and total hospitalization time were compared between the two groups. Levels of white blood cell count, red blood cell count, hemoglobin, serum albumin, high-sensitivity C-reactive protein, and microbial culture positivity rates were measured before and after treatment. Visual Analog Scale (VAS) scores, Braden pressure ulcer risk scores, and Self-Rating Anxiety Scale scores were evaluated. Adverse reactions and complications were recorded. Pearson correlation analysis or Spearman rank correlation analysis was used to explore the relationship between anxiety and various prognostic indicators.

RESULTS

The research group had a higher overall wound healing rate (92.00% vs 76.00%, P < 0.05), shorter wound healing times and total hospital stay (P < 0.05). At week 8, the research group had lower white blood cell counts, high-sensitivity C-reactive protein levels, and microbial positivity rates, while having higher red blood cell counts, hemoglobin, and albumin levels compared to the control group (P < 0.05). At weeks 4 and 8, the research group had lower VAS and Self-Rating Anxiety Scale scores than the control group, but higher Braden scores (P < 0.05). The incidence of complications was also lower in the research group than in the control group (8.00% vs 22.00%, P < 0.05).

CONCLUSION

Encouragement-based interventions guided by Watson’s caring theory can effectively alleviate pain and anxiety in patients with stage III-IV pressure ulcer infections, improve nutritional status and inflammatory responses, promote wound healing, shorten hospitalization time, and reduce the risk of complications. This approach demonstrates significant clinical application value and is worthy of promotion.

Keywords: Watson’s caring theory; Encouragement-based intervention; Stage III-IV pressure ulcers; Infection; Pain; Anxiety; Prognosis

Core Tip: Encouraging interventions based on Watson’s theory of caring can effectively alleviate pain and anxiety in patients with stage III-IV pressure ulcer infections, improve their nutritional status and inflammatory responses, and reduce the risk of complications, thereby demonstrating significant clinical application value.

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